February 4 is observed as World Cancer Day globally, to raise awareness about the disease, which is easily the most dreaded disease in the world. While cancers of the lung, breast, and prostate are the most common, an increasing incidence worldwide has made Esophagus Carcinoma, also known as Food Pipe Cancer, the 8th most common cancer in the world, says Dr Prriya Eshpuniyani, Consultant-Thoracic OncoSurgery, Hiranandani Hospital,  Vashi - A Fortis Network Hospital. She adds that Squamous Carcinoma was more common in Asian countries secondary to poor nutritional status with excessive tobacco (smoke and smokeless)."However, in the recent few years, the number of Adenocarcinoma Esophagus cases has been increasing in incidence due to increasing Obesity and Gastroesophageal Reflux Disease (commonly known as Heartburn)," Dr Eshpuniyani said.


6 Warning signs of Esophageal Cancer 


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Dr Prriya Eshpuniyani lists six warning signs of Esophageal Cancer 


 1. Difficulty in swallowing: It begins with solids, with the need for water to push solid food down, and increases gradually to semisolids and liquids. It is sometimes associated with pain, however, most of these patients don’t notice it, as it is painless in the initial stages. It usually requires the food pipe to get blocked more than 2/3rd, to cause difficulty in swallowing; this leads to delayed diagnosis in our country.


2. Heartburn: Acid from the stomach gets refluxed in the Esophagus and changes the lining of the Esophagus, leading to Adenocarcinoma. This is seen more commonly in obese patients with a history of a sedentary lifestyle, unhealthy eating habits, and persistent reflux symptoms. It’s also seen in chronic smokers. Awareness of the high risk of conversion of “acidity” symptoms to Cancer is needed to ensure an early visit to a doctor, and a timely endoscopy is necessary to catch the changed in the esophagus in the early stage.


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3. Weight loss: Unexplained weight loss without making any efforts, along with a lack of appetite can be an indicator.


4. Hoarseness of voice: A change in voice to heavy or hoarse can happen due to the involvement of nerves.


5. Blood in vomit: Because of the bleeding of the tumour in the food pipe, there can be blood in the vomit.


6. Persistent cough and blood in the cough: Due to pressure of the tumor on the airway, or invasion into the airway, there's this persistent cough, which can also include traces of blood. 


7. Pain between shoulder blades: This can also be a symptom.


"Timely evaluation by an onco-surgeon with an early referral for endoscopy in high-risk patients or patients with mild symptoms is crucial to catch an early stage of Esophageal Cancer or in premalignant stage for an increased chance of complete cure," Dr Prriya Eshpuniyani adds.